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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_15 | Pages 44 - 44
7 Aug 2024
Raghu A Kapilan M Ibrahim M Mushtaq S Sherief T
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Introduction

Most common osteoporotic fracture

20-30% of patients with OVFs are presented to hospital while 2.2 million remain undiagnosed, as diagnosis is usually opportunistic

66,000 OVFs occur annually in the UK with increase by 18,000 cases a year until 2025.

20% chance of another OVF in next 12 months and 3 times risk of hip fracture.

Acute painful OVFs poorly tolerated by infirm elderly patients, leading to significant morbidity and 8 times increase in age-adjusted mortality.

Materials and Methods

Classify fracture severity and patents with ovfs in 12-month period.

To assess follow-up status and if kyphoplasty was offered within 6 weeks as per NICE guidelines.

To introduce Royal Osteoporosis Society and GIRFT guidelines on management of symptomatic osteoporotic vertebral fractures


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 346 - 346
1 Jul 2008
Abraham A Mountain A Sherief T Green S Roysam S Sher J
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Background: The usefulness of the Nottingham Health Profile as a generic quality of health outcome measure has been described in a number of Orthopaedic conditions. This study was done to compare two quality of life questionnaires, the Nottingham Health Profile (NHP) and the Oswestry Disability Index (ODI) regarding the internal consistency, validity and responsiveness as outcome measures in patients undergoing surgery for lumbar nerve root decompression. We also assessed the effects of smoking, type of lesion, clinical presentation, number of levels involved, operating surgeon and duration of symptoms.

Methods: 37 patients with clinical nerve root entrapment, confirmed radiologically were treated with decompression surgery by two surgeons. We used the NHP and the ODI to assess the severity of symptoms prior to and at 3 and 8 months following surgery

Results: We were unable to detect factors predictive of better healthcare outcome scores after surgery for sciatica. There was a statistically significant improvement in the total ODI score and all NHP domain scores within the whole cohort, after treatment. NHP had a greater responsiveness in detecting improvement for pain and physical ability as measured by the effect size. Cronbach’s alpha for reliability of scores was consistently above the acceptable threshold of 0.90 for NHP scores and consistently below 0.90 for ODI scores. A “floor and ceiling” analysis revealed that the NHP consistently skewed scores at 3 months post op towards a better outcome compared to the ODI.

Conclusion: The generic Nottingham Health Profile appears to be a more sensitive health questionnaire than the Oswestry Disability Index in assessing the outcome of nerve root decompression surgery. We were unable to identify factors predictive of better outcomes using these scores as outcome measures.